Clinical Analysis of Approach Selection of Extraction of Maxillary Embedded Mesiodens in Children

OBJECTIVE: To analyze the relationship between the position of embedded mesiodens in maxilla and surgical approach in children and thus provide reference materials for surgical design. METHODS: According to the preoperative cone-beam computed tomography (CBCT) examination, the location and surgical approach characteristics of 625 children aged 4-16 years old who presented with embedded mesiodens in maxilla and were diagnosed in our department from January 2016 to December 2021 were statistically analyzed. RESULTS: There were 877 embedded mesiodens in 625 children. The selected cases were classified according to the axial angle relationship between mesiodens and adjacent normal teeth or tooth germs, including 84 cases of acute angle type (including the same direction) (13.4%), 66 cases of vertical type (10.6%), 114 cases of obtuse angle type (18.2%), 271 cases of inverted type (43.4%), and 90 cases of mixed type (14.4%). The palatal gingival margin approach was the most selected surgical approach for the cases of acute angle (including synclastic), obtuse angle, and inverted type, and the palatal gingival margin approach and the combined labial-palatal approach were the most selected surgical approach for the cases of vertical and mixed type. CONCLUSION: Palatal gingival margin approach was the most common surgical approach for various types of embedded mesiodens in maxilla in children. Surgeons should classify the case of mesiodens according to the preoperative imaging examination and design the surgical approach reasonably.